| Image Number 479 (Lentigo Maligna) |
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Site: Arm,forearm
Diagnosis: Lentigo Maligna
Morphologies:
Large polygons
Sex: F
Age: 69
Type: Heine
Submitted by: Dr Jeffrey Keir
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Description:
A 7 mm diameter lesion on the forearm of a 67 year old female. There are obvious large polygons in this in-situ lentiginous melanoma. The background pattern of the lesion appears to be a solar lentigo-like homogeneous light brown, but with some edges lacking the typical sharp cutoff of solar lentigo.
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History: Large Polygons - a dermoscopic feature of Lentiginous Melanoma
see PDF here
21/27 non-facial lentiginous melanomas detected over a 2 year period had these structures.
These polygonal shapes may be obvious and complete or subtle and incomplete. They are defined by darker grey or brown relatively straight lines, or by darker (sometimes only barely so) surrounding lesional pigment or a combination of the two. They are much larger than the rhomboidal structures seen in facial lentigo maligna and may be rhomboidal, pentagonal, or hexagonal. In some cases the large polygons do appear to be centred on follicular openings, as in lentigo maligna of the face, but this is not a constant.
I have termed these shapes “large polygons”, in contrast to the smaller rhomboidal structures seen in facial lentigo maligna.
Large polygons usually occurred within a pigmented lesion that had lentigo-like pigment patterns, but lacking the sharply defined scalloped edge usually seen with solar lentigo.
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